May 21, 2024
Claim Reconsideration Requests and Corrected Claims All claim requests for reconsideration and corrected claims must be received within 90 calendar days from the date of the Explanation of Payment (EOP). If a provider has a question or is not satisfied with the...
May 13, 2024
How to Fill the National Provider Identifier (NPI) Application/Update Form The National Provider Identifier (NPI) is a unique identification number assigned to healthcare providers in the United States. It is essential for providers to have an NPI in order to conduct...
Dec 11, 2023
TFL denial reasons codes and action plan CO – 29 – The time limit for filing has expired. Amerigroup/BCBS of WNY: Timely filing 120 days from the DOS. Contact Provider Relations to discuss timely filing denials. HealthFirst: Children’s timely filing claim...
Sep 25, 2023
CPT Code and Description 10030 – Image-Guided Fluid Collection Drainage By Catheter (Eg, Abscess, Hematoma, Seroma, Lymphocele, Cyst), Soft Tissue (Eg, Extremity, Abdominal Wall, Neck), Percutaneous. 10035 – Placement Of Soft Tissue Localization Device(S)...
Aug 7, 2023
CPT Code and Description 0059U – Oncology (Merkel Cell Carcinoma), Detection Of Antibodies To The Merkel Cell PolyomaVirus Capsid Protein (Vp1), Serum, Reported As Positive Or Negative. 0060U – Twin Zygosity, Genomic-Targeted Sequence Analysis Of...
May 15, 2023
CPT Code and Description 64490 (cervical or thoracic) or 64493 (lumbar or sacral) reports a single level injection performed with image guidance (fluoroscopy or CT). Procedures performed under ultrasound guidance are not covered. 64491 or 64494 describes a second...
Apr 11, 2023
Covered Services: a. Except for specific laboratory tests identified under non-covered services, the Division of Health Care Financing and Policy (DHCFP) reimburses organ or disease oriented panels, therapeutic drug assays, evocative/suppression testing, clinical...
Feb 9, 2023
CPT Code and Descripiton ▪ 29824 – Arthroscopic claviculectomy including distal articular surface ▪ 29827 – Arthroscopic rotator cuff repair ▪ 29828 – Biceps tenodesis Coding and Billing Guidelines. Description of Special Study: The CERT review contractor conducted a...
Dec 15, 2022
Cerebrovascular Arterial Studies (93880-93893) 93880 Duplex scan of extracranial arteries; complete bilateral study 93882 Duplex scan of extracranial arteries; unilateral or limited study (To report common carotid intima-media thickness (IMT) study for evaluation...
Oct 12, 2022
Colonoscopy Billing Tips – CPT 45380, 45385 As a speaker at many national conferences, I find the question most frequently asked is, “What is the proper way to code a screening colonoscopy?” First, let’s talk about what is a screening colonoscopy. Physicians suggest a...
